Inspection on 12/06/07 for Whitstable Nursing Home

This inspection was carried out on 12th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Whitstable Nursing Home 21/06/06

Whitstable Nursing Home 06/02/06

Whitstable Nursing Home 13/06/05

Whitstable Nursing Home 08/10/04

Whitstable Nursing Home 27/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Whitstable Nursing Home 27-28 West Cliff Whitstable Kent CT5 1DN Lead Inspector Mrs Susan Hall Key Unannounced Inspection 12th June 2007 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whitstable Nursing Home Address 27-28 West Cliff Whitstable Kent CT5 1DN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 265443 01227 264440 kan.rajakanthan@njch.co.uk Unique Help Group Limited Post Vacant Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2006 Brief Description of the Service: The Whitstable Nursing Home is part of the Unique Help Group Limited, which was purchased by Nicholas James Care Homes Limited in 2006. The Company have a number of other nursing and care homes in the South East region. The home is a large, detached property, situated in a residential area of the town. It is close to local shops and amenities, and the seafront. Nursing care is provided for up to 34 older people. Residents state that it provides a homely and friendly environment. Accommodation is provided on two floors, and comprises 20 single rooms and 7 shared rooms. Some of these have en-suite facilities. There is a passenger lift and a stair lift for easy access between floors. Communal space is provided in several different lounge areas and a dining room on the ground floor. There are gardens to the rear and the side of the property. The home has off road parking spaces for visitors, and there is additional parking available on the road. The fees range from £468 to £650 per week, depending on the allocated room, and the levels of nursing care required. This information was provided by the manager on the day of the inspection visit. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key Inspection, which includes gathering information since the time of the last inspection in June 2006. This includes phone calls and letters into the office, formal notifications from the home, any concerns or complaints recorded during that time, and survey forms from residents, relatives and health professionals. The Inspector had a good response from the survey, with a total of 16 completed forms, most of which had been completed by residents or relatives. These were all positive in their content, and included comments such as “It is a very relaxed atmosphere when you walk into the home”; “we are very pleased with the care and support received”; and “I am very happy with the progress my relative has made since arriving here, and am happy with the facilities provided.” There have been four concerns raised to CSCI since the last inspection – one about staffing levels; one about fee payments; one about a possibly inappropriate placement; and one about staffing contracts. No complaints were raised directly with CSCI. These matters were passed on to the Provider to investigate, and were appropriately dealt with. A referral was made to the Social Services Adult Protection team in regards to a resident’s injury after a fall. This allegation was substantiated. The Provider responded by implementing updated moving and handling staff training in the home, and ensuring that procedures are properly followed. The above incidents all occurred prior to November 2006, and there have been no concerns, complaints or allegations forwarded to CSCI since that time. A new manager was appointed in September 2006, and has brought increased stability and leadership into the home. She was available throughout the day to assist with the inspection process. The Inspector also talked with seven residents, one relative, and eight staff during the course of the day. What the service does well: The staff promote a very friendly and homely atmosphere, while still retaining a professional attitude towards their work. A relative commented: “The home is extremely good about keeping me up to date with information; everything is explained by the carers and nurses, and they are friendly and co-operative.” Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 6 Care plans are very detailed, and confirm that health and care needs are met, and that appropriate referrals are made to other health professionals (e.g. GP, dietician, physiotherapist etc.). There are good quality assurance procedures in place. The staff actively involve friends and relatives wherever possible, and enable feedback to take place on a daily basis. Residents and relatives meetings are held in the home, and changes are being implemented as a result of these meetings. This gives people the confidence to know that their concerns and ideas will be listened to, and acted on. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 (Standard 6 does not apply in this home). People who use the service experience good quality outcomes in this area. The home has good processes in place to enable residents to make an informed decision about moving into the home. EVIDENCE: The statement of purpose and service users’ guide are well produced documents, which include all relevant and required information. They have both been updated to show that a new manager was appointed last year. Both documents include the home’s complaints procedure, with additional sources for contact in the service users’ guide. The documents can be printed in a large typeface on request. The registration certificate, insurance certificate and complaints procedure are all displayed in the front entrance hall, and a copy of the last inspection report is available for visitors to read. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 10 Pre-admission assessments are carried out by the manager or her deputy, and the Inspector viewed a recently completed assessment. This contained detailed information in regards to medical history, current health needs, mental state, social needs and dependency needs. The manager ensures that the proposed room will be suitable for the resident in terms of it’s size and any necessary equipment (e.g hoisting facilities can be taken into the room), and that equipment (such as a pressure-relieving mattress) is in place prior to the admission. A relative of a newly admitted resident said that the home had been very good with supplying all the information they wanted, and very helpful with the management of the admission. Residents and relatives are encouraged to look round the home, and meet staff and other residents before making a decision about staying. All admissions are for a trial period of four weeks, and a review is held at the end of this time to check the suitability of the placement. Another relative stated “we received ample information and a full tour of the home before deciding on this one.” All residents are supplied with a contract – either a private contract with the home, or an agreed contract with a Local Authority. Fee levels are specified. The service users’ guide explains terms and conditions of residency. New residents and relatives are encouraged to personalise the room, so that the resident feels at home more quickly. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 People who use the service experience good quality outcomes in this area. There is good management of care plans; and health needs, including medication, are properly met. EVIDENCE: The Inspector viewed 3 care plans, including one for a newly admitted resident. Care plans are stored in large lever arch files, and are very detailed. Nursing care is based on the Roper’s model of activities of daily living, with assessments for each section. These include risk assessments and dependency assessments, such as: falls risk assessment, nutrition assessment, moving and handling, personal hygiene management and risk of developing pressure ulcers. Each section is very comprehensive, and covers other aspects of care such as sleeping (with preferred details about going to bed, and if the person likes a hot drink before bed etc.); communication; continence management; wound care; use of bed rails; diabetes care; and medication. Care plans and accompanying assessments are re-evaluated and updated each month. Residents and relatives sign to show their involvement with care planning. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 12 The care plans are indexed for easy access of information. Other sections include records of visits from GPs and other health professionals or care management; and daily reports. Visits are clearly recorded, with details of any changes in treatment, tests to be done (e.g. blood or urine tests), or referrals to other health professionals. The Inspector saw details of referrals and visits for physiotherapy, hospital appointments, and specialist nurses such as a diabetic nurse. Other visits are arranged for professionals such as Speech and Language Therapist, Occupational Therapist, dentist, chiropodist and dietician. Daily reports are written by the nurses, and are well completed, and appropriately signed, timed and dated. Care staff report any changes or concerns to the nurses during the shifts, and complete ongoing charts, which include fluid charts and turn charts for residents who are unwell. Residents who are unable to use a call bell for any reason, have hourly checks if they are in their own rooms. Care staff also complete hygiene records showing if a bath or bed bath has been given, shave, nail care etc. Comments from relatives include “I’m glad there is a Nursing Home which can give my relative the care and attention they need”; and “ there is excellent care, carried out in a cheerful and friendly manner. The staff are kind and caring, and carry out their tasks with a high degree of professionalism.” Medication is stored in a small clinical room on the ground floor. There had been problems with the room and drugs fridge temperatures being too high at the last visit. This has been resolved, and temperatures are now within the required guidelines. The medicine trolley and stock cupboards are in good order. There is no overstocking, and there is evidence of stock rotation. Controlled drugs (CDs) are stored properly in a CD cupboard which meets requirements. There is a good self-medication policy in place, with a competency assessment. Bottles of medicines, eye drops and insulin, are dated on opening. Medication Administration Records (MAR charts), were examined for all residents. These are good clear records, properly maintained, and including a photograph of each resident. Allergies are clearly specified. Medication is receipted in on the MAR charts; and two nurses sign any handwritten entries. Death and dying are referred to during the admission process, giving residents the opportunity to discuss any particular wishes, and if the person wants to talk about this, or have any help. Residents are enabled to have visitors whenever they want, and staff make sure they are kept as comfortable and pain free as possible. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use the service experience good quality outcomes in this area. The staff are working towards improving the type and number of activities available, including more outings. Food is well prepared, and is nutritious and wholesome. EVIDENCE: The manager and deputy had been discussing how to increase activities prior to the arrival of the Inspector. Residents meetings, and comments from residents and relatives, have raised concerns that there are not currently enough activities available for residents. This has been clearly acknowledged, and the manager and staff are working towards improving this situation. One of the kitchen assistants now has a secondary post as an activities co-ordinator for three afternoons per week. Residents have weekly bingo, which they enjoy, and other activities such as reminiscing, quizzes, games etc. Entertainment is sometimes organised, with singers or dancers etc. coming in. The home is hampered by lack of specific funding for activities, and currently raises funds (e.g. via raffles) for items to assist with activities. (This is further addressed in the section on Management). Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 14 There has been little facility for residents to go out together until recently, but the manager has now arranged for a minibus from another home (plus driver) to come to the home every week (or two weeks) to take some residents out. The manager tries to make provision for key workers to take individual residents out each week where possible, and if the weather is good enough. Additional care staff are brought in to cover for these hours. Residents appreciate this, and enjoy going out on a one to one basis for shopping, or to the market, or for walks by the sea etc. The manager recognises there is insufficient stimulation and attention available for residents who are confined to bed as well, and is looking at how to address this situation. There was an acknowledgement that the home has not got this area right yet, but staff are determined to work to improve it. Visitors are made very welcome, and can sit outside on the patio or in lounges/dining area with residents. It is very much a homely atmosphere, and residents are happy that their dining table is used for staff meals, and they will often sit and talk together while dining. (There is a separate staff facility for staff to have breaks away from residents too.) Visitors are usually offered tea or coffee, and can stay for meals by arrangement. The Inspector had 12 completed survey forms back from residents and relatives, and without exception, these commented on the home’s warm and friendly atmosphere, and the good care for visitors as well as residents. There is an emphasis on encouraging residents to maintain their independence as much as possible, and to ensure they are enabled to express individual choice. This was noticed in regards to getting up, going to bed, where to sit, going out, having different meal choices from what was on the menu etc. If residents are unable to act for themselves, and do not have anyone to act on their behalf, advocacy is discussed during the pre-admission process, and there are details readily available for arranging this. The kitchen is overseen by a cook who has completed NVQ 2, and has many years of experience in catering. The manager, cook and residents had just drawn up new menus, to accommodate residents’ changing preferences. A complaint had been voiced that menus were insufficiently interesting, and it was good to see that these comments had been taken on board and acted on. There is a choice of main course and dessert, at each meal. The cook is familiar with managing soft diets, and specific diets such as diabetic. Custards and soups are fortified with cream etc, where possible, to make them more nutritious. Residents said that the food is of good quality and quantity, and lunches were seen to be well prepared and presented. Fruit is cut into small portions every afternoon, and a choice of fruit or ice cream cone is offered mid afternoon with the tea trolley. Residents love having ice cream cones in hot weather, and appreciate the fruit in a presentation which is easy to manage. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good quality outcomes in this area. Complaints are appropriately investigated, and dealt with promptly and appropriately. Residents are protected from abuse EVIDENCE: The home’s complaints procedure is clearly displayed in the entrance hall, and includes detailed information, directing people who may wish to complain to the relevant departments. An abridged version is included in the statement of purpose and service users’ guide. Complaints are recorded on separate complaint sheets, and show the action taken in response to the complaint. The home had received three since the last inspection, and the records showed that appropriate action had been taken in each case. CSCI received concerns directly from four different sources prior to November 2006. These were passed on to the Provider for investigation, and were also dealt with thoroughly and appropriately. No concerns or complaints have been received directly by CSCI since November 2006. One incident was referred to the Social Services Adult Protection team in September 2006, in respect of poor management for a resident in regards to moving and handling. This allegation was substantiated. The company responded by updating the moving and handling training for all staff. Residents survey forms showed that residents feel able to voice their opinions, and know who to talk to if they have any concerns. This is usually their key Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 16 worker, or the manager. Relatives stated on survey forms that there is a good rapport with staff, and they are able to talk to the manager or staff at any time. Staff training records include training in the Protection of Vulnerable Adults (POVA). The company have a manager in another home who is trained to deliver this training throughout the company. New staff have POVA first checks and Criminal Record Bureau checks prior to commencing work, and two written references are obtained. Other recruitment procedures are satisfactory, and assist in ensuring that only suitably screened people are able to work in the home. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 People who use the service experience good quality outcomes in this area. The home provides a friendly and welcoming environment, and there is an effective strategy in place for ongoing refurbishment. EVIDENCE: The Inspector viewed all areas of the home, and there were noticeable improvements from the last visit. An ongoing programme of redecoration and refurbishment has enhanced the premises, and it is generally well maintained. One survey included: “the home is clean, hospitable, and decorated in a homely way.” A team of maintenance men work between the homes in this group, and are allocated to different homes as the need arises. There have been some improvements to outside areas, with patio slabs re-laid, and work done to make a more discreet area outside for clinical waste and rubbish bins. The home would benefit from more attention to the gardens, but there is still a pleasant area for residents and relatives to sit outside. There is a Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 18 large patio at the back which is largely unused, and the manager said she is hoping to buy some garden furniture, and use this area for barbecues in the future. Inside the home there are three lounge areas – all leading through from each other - and these provide a choice of areas for residents to sit in. This is in addition to the dining area, which is a popular gathering place, and at the heart of the home. It is adjacent to the manager’s office, and enables residents and relatives to have frequent, relaxed contact, with the manager and staff. Most bedrooms have been redecorated, and there was some new furniture in evidence. New carpets have been fitted in most bedrooms, corridors and communal areas. Some bedrooms have en-suite toilet areas, and all others have washbasins. There is an ongoing programme for fitting new vanity units. The manager said that new soft furnishings were being purchased on a rolling programme. Bedrooms are personalised with residents’ own items. There are five bathrooms, and five separate toilets, in different areas of the building. They are sited close to bedrooms and communal areas. The bathrooms include a “Parker” bath, and baths with hoisting facilities. Some work is still needed to upgrade some of these areas, and there is a programme of work which is ongoing. One of the bathrooms is not currently used, as it does not provide easy bath access for residents. The manager said this was being reviewed as a possible shower room, which would be a good use, as it would provide residents with a choice of bath or shower. The home has sufficient equipment in place, including two hoists and a standaid, new nursing beds, pressure-relieving mattresses, grab rails, and a call bell in each room. There is a passenger lift and a stair lift for access between floors. Care staff ensure that there is supervision for residents using the stair lift. Radiators are all fitted with guards, and maintenance checks are carried out for hot water temperatures, ensuring that thermostats are working correctly. There are four sluices provided in key areas, and this includes a sluicing disinfector. The home was clean in all areas, and there were no offensive smells. The laundry room is fitted with a commercial washing machine and separate tumble dryer. A laundry assistant is employed during the mornings, and care staff have job allocations in the afternoons, which include overseeing the laundry area. Kitchen areas highlighted at the last inspection had been attended to. The manager said that the Provider is intending to refurbish the kitchen with new units in due course. The current units are old and will need replacing before too long. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use the service experience good quality outcomes in this area. Staffing levels have been improved, and this is having a positive effect on the home. There are good recruitment and training procedures in place. EVIDENCE: Staffing levels have been increased since the last inspection, and provide much better opportunities for staff to care effectively for residents. As this is a nursing home, there is always a nurse on duty throughout the 24 hours, and in the daytime, there is usually the manager or deputy manager as well. They work together for one to two shifts per week, which enables discussions and feedback, and continuity of care. Staffing levels include 5 care staff in the mornings, 4 in the afternoons and evenings, and 2 at night. One of the carers is currently allocated to prepare evening meals, and starts the afternoon shift in the kitchen, and does not leave kitchen work until the meals are over, and the kitchen is cleared and cleaned. There is then approximately an hour left to carry out care work, assisting to put residents to bed who wish to go early. This system seems to work well in this home, and includes good infection control procedures. Care staff are employed for additional hours for escort duties to take residents for hospital/optician appointments, and to take residents out on a one to one basis. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 20 The home has good records for staff training, showing that mandatory training (e.g. moving and handling, fire awareness, infection control, basic food hygiene) is carried out during the first few weeks. Records showed that mandatory training is up to date, and that other training such as dementia care and adult protection is carried out to increase staff knowledge and understanding. The home uses the “Skills for Care” induction programme, and the manager mentors new staff through this process. NVQ training is encouraged, and the NVQ Assessor comes into the home. 7 care staff have completed NVQ 2 or 3 training, and another 5 were in the process of working for NVQ 2. When these have successfully completed training, the percentage will be over 50 . Recruitment procedures were checked against 3 staff files. These showed that good procedures are in place, and include POVA First and CRB checks, two written references, proof of identity, and records of previous employment. The Inspector noted that one of the application forms used recently was an old one, and did not specify that a full employment history must be obtained. This was pointed out to the manager. PIN numbers are checked for nurses, and previous records of training. Nurses are enabled to update their own skills and competencies, with opportunities for training in subjects such as venepuncture and wound care. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-38 People who use the service experience good quality outcomes in this area. There are good management processes in place, and the manager is working to improve services, and to provide a clear lead to other staff. EVIDENCE: The manager has been in post since September 2006, and is a level I trained nurse. She is currently working towards the Registered Managers’ Award, and has applied to CSCI for registration. The home has made some good improvements in the last year, and the change of management has been a contributory factor in this. Staff, residents, and relatives showed a confidence in her leadership, and she is clearly developing an effective management style. She spends time working on the “floor”, and so gives direct leadership and support to other staff. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 22 Formal and informal residents meetings, and staff meetings, are held in the home, and these enable people to express their points of view, and help to bring about change. An example of this is that residents asked for a change in the menus to provide more variety, and this has been discussed with the cook, manager and residents, and was just in the process of being implemented. In-house questionnaire forms are distributed once/twice per year, so that residents can give anonymous feedback if they wish to do so. Monthly visits are carried out by senior management in the company. The home’s financial viability was evident in the money spent on redecorating and refurbishment. However, the manager is not included in budgeting procedures, and does not currently have a budget for managing residents’ activities/outings and petty cash. There is a recommendation for this to be reviewed, so that there is a better facility in place for arranging activities and outings. The only money handled for residents, is small amounts of pocket money. This is stored safely in individual amounts, and all transactions are recorded with two signatures. The resident or their next of kin/advocate can view these records at any time. There are good systems in place for one to one formal staff supervision, which is carried out every two months for all staff. Policies and procedures are stored in the office where they can be easily accessed by all staff. They had all been reviewed within the last year. New medication policies had been drawn up, and the Inspector read these, and noted that they are clearly written, and in a style which is easy for all staff to understand. Other records are generally well maintained and up to date. The maintenance team oversee records for fire drills, emergency call bell checks, building risk assessments and general maintenance – such as hot water temperatures. The maintenance records were in good order. The fire risk assessment had been drawn up in 2005, and the manager was unsure if this included the requirements for the Regulatory Fire Reform. The fire officer has already been booked to visit the home in July 2007, and will be checking that all fire precautions are up to date at that visit. Fire extinguishers were dated May 2006, and the manager said that she would ensure that the annual check is carried out. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 2 3 3 3 3 Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP12 Regulation 12 (1) (a) Requirement To ensure that a sufficient range of activities is implemented for residents. Timescale for action 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP21 OP19 OP29 OP34 OP38 Good Practice Recommendations To continue with the upgrading programme for bathrooms, with particular reference to the unused bathroom on the ground floor. To maintain continued improvement for the gardens and outside areas. To ensure that all applicants are requested to complete a full employment history. To ensure there is an effective system in place for budgeting for residents’ activities. To ensure that fire equipment is checked annually. Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Whitstable Nursing Home DS0000026127.V340159.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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